More than 11% of adults in the United States have high total cholesterol levels, which increases the risk of heart disease, heart attack, and stroke. Statins are medications commonly used to treat high cholesterol, but they may cause side effects or complications in some cases.
This article explores natural alternatives to statins and addresses common questions asked by patients and practitioners.
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Understanding Cholesterol and Statins
Cholesterol is a waxy substance found in the blood. The human body makes it, while animal-based foods are a dietary source of cholesterol.
The body needs some cholesterol to function properly, but too much cholesterol can lead to health problems. Excess cholesterol can stick to blood vessel walls and narrow or block them, increasing the risk of heart disease.
The different types of cholesterol in the body are as follows:
- Total cholesterol: total amount of cholesterol circulating in the bloodstream
- High-density lipoprotein (HDL) cholesterol: beneficial cholesterol that clears out excess cholesterol within the body to prevent narrowing or blockages
- Low-density lipoprotein (LDL) cholesterol: harmful cholesterol that contributes to plaque buildup in blood vessels, increasing the risk of a heart attack and stroke
- Triglycerides: type of fat that, when present in excess in the bloodstream, increases the risk of a stroke and heart attack
Cholesterol is used in the body to make hormones, vitamin D, and cell membranes. It also helps make bile, a fluid produced by the liver and stored in the gallbladder that aids in digestion.
Statins help reduce LDL cholesterol (unhealthy form of cholesterol) by slowing down the production of cholesterol made by the liver and increasing the body’s ability to eliminate LDL cholesterol. These medications slow plaque formation, reducing the chance of a heart attack or stroke in individuals with high LDL cholesterol.
Statins also help increase HDL cholesterol (healthy cholesterol) and lower triglycerides to minimize the risk of heart problems.
However, common side effects and concerns associated with stains include a higher risk of type 2 diabetes in individuals with diabetes-related risk factors, such as obesity, metabolic syndrome, and prediabetes. Statins might contribute to abnormal liver enzyme test results and (in rare cases) liver damage, muscle damage, muscle pain, rhabdomyolysis (muscle breakdown), or kidney damage.
Furthermore, pregnant and nursing women and people with liver diseases should not take statins.
Lifestyle Changes as Alternatives to Statins
Fortunately, diet and other lifestyle modifications help lower cholesterol naturally. Consuming the following nutrient-dense foods can help reduce cholesterol levels:
- High-fiber plant foods: fruits, vegetables, whole grains (particularly oatmeal and oat bran), nuts, seeds, avocados, and legumes. Aim for at least 25 grams (women) and 38 grams (men) of fiber per day.
- Omega-3 fatty acids: sources include salmon, tuna, herring, trout, sardines, mackerel, other fatty fish, omega-3 supplements, plant-based omega-3 sources (soybeans, canola oil, soybean oil, flaxseed oil, flax seeds, walnuts, chia seeds, etc.), and foods and drinks fortified with omega-3 fatty acids.
- Plant-sterols and stanols: sources include fruits, vegetables, nuts, seeds, legumes, and whole grains.
- Whey protein: sources are whey protein supplements, milk, yogurt, and other dairy foods.
- Olive oil: the Mediterranean diet is rich in olive oil, which studies show can reduce cholesterol naturally.
Some dairy foods are fortified with cholesterol-lowering phytosterols. Sterol, stanol, omega-3, and fiber supplements are available too.
A sample cholesterol-lowering meal plan (with recipes linked) is as follows:
- Breakfast: oatmeal prepared with milk or plant milk topped with nuts, seeds, and fruit — plus egg whites
- Snack: whey protein smoothie
- Lunch: turkey burger or veggie burger on a whole-grain bun, topped with veggies and mashed avocados
- Snack: veggies dipped in hummus
- Dinner: pan-seared salmon nuggets, asparagus sauteed in olive oil, feta cheese, and quinoa
- Snack: popcorn, mixed nuts, or roasted chickpeas
Exercise plays a critical role in reducing cholesterol levels naturally. The American Heart Association recommends completing at least 150 minutes of moderate-intensity aerobic exercise (walking, jogging, swimming, cycling, etc.) weekly.
Add in weight-training exercises at least 2-3 times each week to maintain an ideal weight, minimize body fat, and boost strength and resting metabolic rate.
Achieving and maintaining a healthy body weight is essential to keeping blood cholesterol levels within normal limits. Researchers found that in overweight and obese individuals, losing just 5-10% of their initial body weight significantly improved cholesterol and triglyceride levels. Making dietary changes, exercising regularly, and getting enough sleep can optimize weight loss.
Another holistic solution for natural cholesterol reduction is minimizing stress. Individuals with high cholesterol who experience extreme or ongoing stress can lighten up a busy schedule and try yoga, tai chi, meditation, massage, time outdoors, walking, or other stress-reducing strategies.
Natural Supplements and Remedies
Natural supplements known to reduce cholesterol include:
- Red yeast rice
- Plant sterols and stanols
- Omega-3 fatty acids, particularly fish oil and flaxseed oil
- Psyllium husk and other fiber supplements
- Berberine
- Garlic
- Green tea extract
- Niacin
Use caution when taking red yeast rice products containing monacolin K, which is chemically the same as an active ingredient in the cholesterol-lowering medication called lovastatin.
Products containing monacolin K can cause the same side effects as this statin, such as muscle, kidney, or liver damage. The Food and Drug Administration (FDA) has not approved supplements containing more than trace amounts of monacolin K.
Individuals should only use dietary supplements for lowering cholesterol under the direction of a qualified healthcare provider, as they may interact with medications and aren’t tightly regulated by the United States Food and Drug Administration (FDA).
While most dietary supplements that have been third-party tested for purity and quality are safe for healthy adults, not all cholesterol-reducing supplements lower cholesterol enough in every individual.
Prescription Medications as Statin Alternatives
Non-statin prescription medications can also help reduce cholesterol in individuals with very high cholesterol or those who haven’t been able to lower cholesterol enough using healthy lifestyle habits alone. Examples include:
- Ezetimibe (cholesterol absorption inhibitor): prevents the body from absorbing cholesterol in the intestines. It’s the most commonly used non-statin medication.
- Bile acid sequestrants (bile acid-binding agents) help the intestine remove extra cholesterol.
- PCSK9 inhibitors (LDL-lowering drugs): bond to and inactivate cell proteins in the liver, lowering LDL cholesterol.
- Adenosine triphosphate-citrate lyase (ACLY) inhibitors: help block the production of cholesterol in the liver.
- Fibrates: reduce triglycerides and slightly lower LDL cholesterol.
- Niacin (nicotinic acid): prescription that limits the production of blood fats in the liver to reduce triglycerides and slightly lower LDL.
The American Heart Association suggests that statins are the most effective LDL cholesterol-lowering medicines.
Consider prescription medications when lifestyle changes or dietary supplements haven’t lowered cholesterol enough or when an individual has very high blood cholesterol levels.
Integrative and Functional Medicine Approaches
Integrative medicine combines traditional Western medicine treatments with holistic, natural options and functional medicine, taking a root-cause approach to care. A root-cause treatment might entail weight loss, nutritional changes, more exercise, reducing stress, and getting more sleep.
Unless an individual’s cholesterol is very high, it is often useful to first try natural solutions. People currently taking cholesterol-lowering medicines may be able to reduce their dosage or eventually wean off of medication entirely after making healthy lifestyle adjustments. Taking a personalized approach to cholesterol-lowering treatment is essential.
A case study of a 33-year-old man with moderately high cholesterol reduced his total cholesterol by more than 40% by consuming a nutritious diet rich in heart-healthy fats combined with moderate exercise for six weeks — without using cholesterol-lowering drugs.
Researchers found evidence that backs recommendations to minimize saturated fats from animal food sources (lard, high-fat meats, butter, etc.), refined carbohydrates, and trans fats while increasing vegetables, fruits, whole grains, fatty fish, or other omega-3-rich foods or supplements, and low-fat dairy foods to reduce cholesterol naturally. They strongly recommend following a Mediterranean meal plan.
Another study confirms that participants who adopted healthy lifestyle habits were effectively able to reduce total cholesterol, LDL cholesterol, and triglycerides.
Monitoring and Managing Cholesterol Levels
Routine cholesterol monitoring using blood tests and effective management is critical to lessen the risk of heart problems and other complications. The American Heart Association suggests that many healthy adults have their cholesterol levels checked every 4-6 years if their cholesterol has been within a healthy range.
After age 40, however, individuals with heart attack and stroke risk factors should be evaluated more often, particularly if they’ve had high cholesterol in the past or are being treated for high cholesterol.
The following cholesterol levels are considered healthy ranges:
- Total cholesterol: less than 200 mg/dL
- LDL cholesterol: less than 100 mg/dL
- HDL cholesterol: 60 mg/dL and higher
Setting realistic cholesterol-lowering goals is important, as it might take several weeks or months after beginning treatment to bring cholesterol levels within an ideal range. Patients should work with a healthcare provider to create a comprehensive, personalized treatment plan.
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Key Takeaways
- It’s highly beneficial to explore alternatives to statins, including dietary changes, exercise, and dietary supplements, to reduce high cholesterol levels naturally.
- Using holistic statin alternatives is helpful to avoid potential side effects or complications these drugs may cause.
- Individuals should consult with a healthcare provider for a personalized solution that effectively treats high cholesterol to avoid heart disease, heart attack, or stroke.
- Using natural cholesterol-lowering alternatives to statins may reduce the need for high-dose medications or eliminate the need for medicine entirely.
Additional Resources
For additional information about exploring natural ways to reduce cholesterol, check out the following resources:
- Academy of Nutrition and Dietetics
- American Heart Association (AHA)
- Centers for Disease Control and Prevention (CDC)
- National Heart, Lung, and Blood Institute (NHLBI)
- John Hopkins Medicine
- Cleveland Clinic
- Mayo Clinic
- Medline Plus
- Dietary Guidelines for Americans
- Family Heart Foundation support groups
- Rupa Health medical experts
Patients and healthcare providers can collaborate to create personalized treatments for lowering cholesterol naturally or combining medicine with holistic alternatives.
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